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DSH140029C COPLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
COPLEY MEMORIAL HOSPITAL
Subdivision Name
RUSH-COPLEY EMERGENCY CENTER - YOR
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140029C
Medicare Provider Number
140029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/19/2016
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Rush University System for Health
Kate Marie Schaafsma, VP, Chief Pharmacy Officer
(815) 592-4299
Primary Contact
Copley Memorial Hospital
Stacey Ries, Deputy General Counsel
(630) 499-4721
Addresses
Street Address
1122W VETERANS PKWY
YORKVILLE, IL 60560-4728
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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